The Great Negative Debate

June 6, 2012

By Jeffrey Benabio, Mike Donavanik, Frank Pizzoli

My best friend is HIV positive and has been for three years. He’s dating a guy who is not, and because my friend is undetectable, he says they’re okay with having unprotected sex. The idea makes me very uncomfortable, but is it my place to say anything? Some studies support the idea, right?

“Courage” via instinctmagazine.com

A: A recent study published in the journal AIDS reveals informative results. Of 101 men in the study, 83 had “undetectable” virus in their blood samples, but 21, or roughly one quarter, had detectable HIV in their semen. That means an undetectable viral load in a guy’s blood is not a guarantee that there is no HIV in his semen. Simply put, your friend’s doctor checks his blood for HIV, not his semen. The study you may be referring to is the 2008 “Swiss study.” Those results indicated that HIV-infected individuals who are on treatment for at least six months, religiously take their medicines, have no other sexually transmitted diseases, are monogamous and have unprotected sex with an uninfected partner may reduce transmission by 96 percent. National Institutes of Health research on positive-negative couples shows if positive partners adhere to treat- ment, there’s a 4 percent transmission rate without condoms. That’s still a high rate. The caveat: The Swiss study included only opposite-sex couples, not gay men. Even so, profiles on man-on- man websites started carrying links to the study, as if to say unsafe sex is okay and your chance of infection is low. See how easy it is to unknowingly or unintentionally misunderstand sci- entific data when you’re not a doctor? Why not suggest to your friend that he ask his beau if they can see his doctor together. Staying negative or not infect- ing a partner isn’t a one-way street or a one-behavior approach. HIV harm reduction is a “strategy” and a set of behaviors and actions. Let a doctor help with all the ins and outs. —FP

Oil Spill

It seems that as soon as the temperature heats up, I start breaking out! My skin gets very oily, and it’s just embarrassing. Should I adopt a new skincare routine for summer?

Jacob via instinctmagazine.com

A: Many men experience breakouts during summertime. Here’s why: Ex- cess sweat, combined with certain sun- screens and lack of exfoliation can clog your skin’s pores, causing acne. Be- cause many guys sweat a lot, their skin (especially on the face) feels greasy, so they use harsh soaps and medicated acne washes that, when overused, can actually create more inflammation and oil production, leading to acne. Most of us need to start with the basics: wash and protect. Use a facial wash that’s mild and moisturizing. I recommend using something like Dove Men+Care’s new Clean Defense Body and Face Wash with “micromoisture” technol- ogy, which is an oil-balancing gel that removes daily oil buildup and leaves a protective barrier of moisture on your skin. If during the day, your skin look shiny, don’t wash it again; use an oil blotting sheet. Even if you have acne, you need to use a daily sunscreen. Choose one labeled “non-comedogenic,” which means it won’t clog your pores, and be sure to wash your sunscreen off as soon as possible when you get home. If you use over-the-counter acne treat- ments that contain benzoyl peroxide or salicylic acid, apply them after you wash your face at bedtime—not in the morning. Both help reduce oil, exfoliate dead skin cells and minimize acne. Pay attention to how your skin is respond- ing. Using too many toners, acne treat- ments and exfoliants will irritate your skin, causing it to produce more oil and ultimately more acne. —JB

Fast Fitness

I don’t have a lot of time to waste in the gym. If I’m going to concentrate on one form of cardio, which exercise am I going to get the most results from? Joseph in Pittsburgh, PA

A: First off, most of us don’t have a lot of time to “waste in the gym.” We need to get in, get out and get on with our lives. Second, every type of exer- cise is going to have its different benefits—so the issue of which one is going to give you the best results isn’t so cut and dry. I tell my clients that the best type of cardio (or any exercise, for that matter) is the kind you enjoy and will do consistently. That said, to maximize the benefit of your cardio work, you should be doing high-intensity interval training (HIIT) for 20-30 minutes. This means you would go hard for X length of time and rest for Y length of time. Depending on your fitness lev- el you may want to first try going hard for 30 seconds followed by 45 seconds of active recovery. If you are an advanced exerciser, you can go hard for 60 seconds and recover for 90 seconds. When I say hard, I mean really hard. For example, if you were on the treadmill, your intense phase should be a sprint of at least 9.5 miles per hour, followed by a recovery jog of about 6.5 miles per hour. If your intense phase isn’t intense enough, you’re not truly reaping the benefits of HIIT and would be bet- ter off doing steady-state cardio. —MD